Integrated medicine

Given the tide of political correctness, sackcloth-and-ashes and
plain kookiness which seems to have been engulfing the BMJ in recent years
I am not surprised by the theme of your current issue. I am, however,
appalled: if we get into bed with alternative medicine we are not only
betraying our scientific heritage but we are also a short step away from
betraying our patients. It has taken hundreds of years to pull medicine
away from the quagmire of superstition, witchcraft, mumbo-jumbo and sheer
quackery and turn it into something resembling a scientific pursuit. Now
all of that progress appears to be in danger of being thrown away because
we are too gutless to stand up to the criticism of scientific rationalism
which is being offered to anyone who will listen. Only this week I have
had to rescue a man from the ministrations of his daughter, who informed
me that she had changed him on to the "homoeopathic equivalents" of
frusemide and an ACE inhibitor, with the result that he was admitted to
hospital in severe heart failure. The likes of Charcot, Semmelweiss, Koch
and Thomas Lewis must be revolving at high speed in their last resting
places if they can see what we are allowing to happen.

Look: there is no necessary opposition between scientific medicine
and humane, holistic clinical practice and the best clinicians throughout
history have been skilled at combining both elements. To suggest that one
cannot be a good scientist and a caring, compassionate doctor is utter,
drivelling nonsense. The bottom line is that the laws of physics and
chemistry are the same the world over and that because of a rigorous
application of these laws and of the principles of the Enlightenment we
now know that malaria is not caused by bad air or curses, that mental
illness is not a sin and that we can prevent outbreaks of typhoid by good
public health measures and vaccination rather than by sacrificing goats at
midnight.